But what makes me REALLY sad about antidepressants is people not taking them

Using the antidepressant Paxil (paroxitene) while pregnant may increase the risk of birth defects, according to two preliminary studies released by the FDA yesterday. The organisation has officially suggested that pregnant moms consider going off or switching their medication. 

The studies - one of 6,000 US babies and the other of 6,900 Swedish babies - found a rise from 1% to 2% and 1% to 1.5% respectively, in the frequency of birth defects for mothers who took Paxil in their first trimester. The most common defects were holes in the infant's heart, which could either be repaired with surgery or will even close themselves.

Worried? Me neither. For one, it's not surprising that there should be some side effects of taking these drugs while pregnant, though it does seem strange that the effects were only found for Paxil and not other antidepressants. Fetuses are fragile things and any chemical imbalance can throw off the whole development party. Recent research in the Journal of the American Medical Association found that babies born to antidepressant-taking moms were more irritable and colicky, and prone to tremors in the weeks after birth.

But a mere 0.5 to 1% increase in risk? Bah. I want to know what would happen to babies born to severely depressed mothers who WEREN'T on medication in their first trimester, or had recently switched medication. I'll hazard one guess: STRESSED OUT. And stress during pregnancy is turning out to be an even huger no-no than previously thought. Read these few sentences from the abstract of this 2005 paper from the American Journal of Reproductive Immunology:

However, stress experienced during pregnancy not only leads to pregnancy complications like miscarriage, pre-eclampsia, preterm parturition, low birth weight or major congenital malformations, stress also increases the risk of the child to develop diseases in the subsequent periods of life. This condition is termed fetal programming of adult disease. Programming agents seem to include growth factors, cytokines and hormones, all of which can be altered by stress. As a consequence, such 'stress-modified' systems of the offspring are more susceptible to environmental influences during later life, e.g. the development of atopic diseases upon exposure to antigens.

Why don't they put THAT on the Paxil box beside the warning that taking it might increase the risk of birth defects in their babies.

In the wake of the teenage-suicide and antidepressant scandal, the FDA is more willing than ever to report every eensy bit of side effect evidence they receive. But depression is still a widely UNDER-treated and stigmatised disease. We need to encourage people to find what works best for them and not scare pregnant moms away from proper treatment. Because despite their "delicate" condition, they might need it most of all.

Comments

[Alom]

It's weird how people respond to depression. I had dinner with a well-known scientist recently who insisted that people with depression were just "miserable" and should just "snap out of it". I was shocked at his attitude since he's actually a really sensible bloke and he should be aware that there is plenty of evidence to suggest that depression is a "real" illness, not just a "mood". Actually, I'm rather envoius of him - he's clearly never been depressed.

I agree with you that we need to "encourage people to find what works best for them". However, I think there is a tendency for GPs to prescribe anti-depressants immediately, rather than properly exploring what treatment might best suit their patients.

For a really good read for anyone who doesn't "get" depression, try "A Malgnant Sadness" by Lewis Wolpert

[Alom]

That should be "A MALIGNANT Sadness".

[anna]

Hey Alom..I totally get with the over prescribing. It's just so much easier than all the cognitive behavioural therapy. You get all the results and none of the effort. Just those pesky side effects.

I also think that pregnant women (along with those who have just given birth) are pretty screwed. Everyway you look, something you are doing is going to give your baby cancer. It's a really complex decision, whether or not to take drugs while pregnant/breastfeeding, and I wish that more women had someone who was well-rounded and compassionate to speak with. I wish that people realised that depression is INCREDIBLY common in pregnant women. And that it is not best to suffer through along. Not best for the mum or the baby.

[MT]

"he's clearly never been depressed."

Maybe. In any event, I know what he tells himself whenever he's on the verge. "Just snap out of it!" I don't think all the people who say this are insensitive. A large number I imagine are trying to validate their own self prescription by getting others to follow it. Simultaneously it's their annoying way of helping. F---ers.

[MT]

"he's clearly never been depressed."

Maybe. In any event, I know what he tells himself whenever he's on the verge. "Just snap out of it!" I don't think all the people who say this are insensitive. A large number I imagine are trying to validate their own self prescription by getting others to follow it. Simultaneously it's their annoying way of helping. F---ers.

[MT]

Drat you Typepad! And on the one time I was being "wise" without the "ass."

[MT]

"he's clearly never been depressed."

Maybe. In any event, I know what he tells himself whenever he's on the verge. "Just snap out of it!" I don't think all the people who say this are insensitive. A large number I imagine are trying to validate their own self prescription by getting others to follow it. Simultaneously it's their annoying way of helping. F---ers.

[Alfred]

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[buddhism]

Today was a complete loss, but oh well. I don't care. So it goes. Nothing going on , but shrug. Not much on my mind these days. Such is life.

[Lee]

Today was a complete loss, but oh well. I don't care. So it goes. Nothing going on , but shrug. Not much on my mind these days. Such is life.